Index: clangd/AST.h
===================================================================
--- clangd/AST.h
+++ clangd/AST.h
@@ -24,6 +24,14 @@
 
 namespace clangd {
 
+// Returns true if the complete name of decl \p D is spelled in the source code.
+// This is not the case for
+//   * symbols formed via macro concatenation, the spelling location will
+//     be "<scratch space>"
+//   * symbols controlled and defined by a compile command-line option
+//     `-DName=foo`, the spelling location will be "<command line>".
+bool SpelledInSourceCode(const Decl *D);
+
 /// Find the identifier source location of the given D.
 ///
 /// The returned location is usually the spelling location where the name of the
Index: clangd/AST.cpp
===================================================================
--- clangd/AST.cpp
+++ clangd/AST.cpp
@@ -11,6 +11,7 @@
 
 #include "clang/AST/ASTContext.h"
 #include "clang/AST/Decl.h"
+#include "clang/Basic/SourceLocation.h"
 #include "clang/Basic/SourceManager.h"
 #include "clang/Index/USRGeneration.h"
 
@@ -18,25 +19,26 @@
 namespace clangd {
 using namespace llvm;
 
-SourceLocation findNameLoc(const clang::Decl* D) {
-  const auto& SM = D->getASTContext().getSourceManager();
+bool SpelledInSourceCode(const Decl *D) {
+  const auto &SM = D->getASTContext().getSourceManager();
+  auto Loc = D->getLocation();
   // FIXME: Revisit the strategy, the heuristic is limitted when handling
   // macros, we should use the location where the whole definition occurs.
-  SourceLocation SpellingLoc = SM.getSpellingLoc(D->getLocation());
-  if (D->getLocation().isMacroID()) {
-    std::string PrintLoc = SpellingLoc.printToString(SM);
+  if (Loc.isMacroID()) {
+    std::string PrintLoc = SM.getSpellingLoc(Loc).printToString(SM);
     if (llvm::StringRef(PrintLoc).startswith("<scratch") ||
-        llvm::StringRef(PrintLoc).startswith("<command line>")) {
-      // We use the expansion location for the following symbols, as spelling
-      // locations of these symbols are not interesting to us:
-      //   * symbols formed via macro concatenation, the spelling location will
-      //     be "<scratch space>"
-      //   * symbols controlled and defined by a compile command-line option
-      //     `-DName=foo`, the spelling location will be "<command line>".
-      SpellingLoc = SM.getExpansionRange(D->getLocation()).getBegin();
-    }
+        llvm::StringRef(PrintLoc).startswith("<command line>"))
+      return false;
   }
-  return SpellingLoc;
+  return true;
+}
+
+SourceLocation findNameLoc(const clang::Decl* D) {
+  const auto &SM = D->getASTContext().getSourceManager();
+  if (!SpelledInSourceCode(D))
+    // Use the expansion location as spelling location is not interesting.
+    return SM.getExpansionRange(D->getLocation()).getBegin();
+  return SM.getSpellingLoc(D->getLocation());
 }
 
 std::string printQualifiedName(const NamedDecl &ND) {
Index: clangd/Quality.cpp
===================================================================
--- clangd/Quality.cpp
+++ clangd/Quality.cpp
@@ -7,6 +7,7 @@
 //
 //===----------------------------------------------------------------------===//
 #include "Quality.h"
+#include "AST.h"
 #include "FileDistance.h"
 #include "URI.h"
 #include "index/Index.h"
@@ -178,7 +179,8 @@
 
   if (SemaCCResult.Declaration) {
     if (auto *ID = SemaCCResult.Declaration->getIdentifier())
-      ReservedName = ReservedName || isReserved(ID->getName());
+      ReservedName = ReservedName || isReserved(ID->getName()) ||
+                     !SpelledInSourceCode(SemaCCResult.Declaration);
   } else if (SemaCCResult.Kind == CodeCompletionResult::RK_Macro)
     ReservedName = ReservedName || isReserved(SemaCCResult.Macro->getName());
 }
Index: unittests/clangd/QualityTests.cpp
===================================================================
--- unittests/clangd/QualityTests.cpp
+++ unittests/clangd/QualityTests.cpp
@@ -45,7 +45,15 @@
 
     [[deprecated]]
     int _f() { return _X; }
+
+    #define DECL_NAME(x, y) x##_##y##_Decl
+    #define DECL(x, y) class DECL_NAME(x, y) {};
+    DECL(X, Y); // X_Y_Decl
+
+    class MAC {};
   )cpp");
+  Header.ExtraArgs = {"-DMAC=mac_name"};
+
   auto Symbols = Header.headerSymbols();
   auto AST = Header.build();
 
@@ -56,6 +64,16 @@
   EXPECT_EQ(Quality.References, SymbolQualitySignals().References);
   EXPECT_EQ(Quality.Category, SymbolQualitySignals::Variable);
 
+  Quality.ReservedName = false;
+  Quality.merge(
+      CodeCompletionResult(&findDecl(AST, "X_Y_Decl"), /*Priority=*/42));
+  EXPECT_TRUE(Quality.ReservedName);
+
+  Quality.ReservedName = false;
+  Quality.merge(
+      CodeCompletionResult(&findDecl(AST, "mac_name"), /*Priority=*/42));
+  EXPECT_TRUE(Quality.ReservedName);
+
   Symbol F = findSymbol(Symbols, "_f");
   F.References = 24; // TestTU doesn't count references, so fake it.
   Quality = {};